Provider Demographics
NPI:1396937512
Name:HOLT, PAMELA CARRIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:CARRIE
Last Name:HOLT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 410W
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7272
Mailing Address - Country:US
Mailing Address - Phone:405-755-8576
Mailing Address - Fax:405-755-6026
Practice Address - Street 1:2601 NW EXPRESSWAY
Practice Address - Street 2:SUITE 410W
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7272
Practice Address - Country:US
Practice Address - Phone:405-755-8576
Practice Address - Fax:405-755-6026
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical